People living with HIV or AIDS in southern states have a higher mortality rate, according to new findings by Duke University.

The South had the nation's lowest five-year survival rate for those diagnosed with HIV/AIDS with 15 percent of people with HIV and 27 percent with AIDS dying within the first five years of their diagnosis.

Louisiana was one of nine southern states with the poorest rates of survival. Younger, rural, African-American females who attributed their HIV infection to heterosexual sex were among the majority of patients with the worse survival rate.

Louisiana had the lowest survival rates after a diagnosis, followed by Mississippi. In Louisiana, 19 percent of people diagnosed with HIV died within five years and one-third of people diagnosed with AIDS died within five years.

"The targeted states with the most concerning mortality statistics, particularly Louisiana, may especially be in need of focused attention on addressing the factors contributing to these concerning statistics," the report stated.

Differences between U.S. regions in demographic characteristics and transmission risk did not explain the higher death rate among persons living with HIV in the targeted Southern states, indicating that other factors contribute to this disparity, according to authors of the study.

Lead author Susan Reif of the Duke Global Health Institute said a number of factors likely contribute to the differences in outcomes seen among individuals living with HIV in the Deep South, including poverty, lower levels of education and insurance coverage, social stigma associated with the disease, and racism.

Dr. Khawar Khurshid, who oversees St. Francis Regional Medical Center's infectious disease department, said the results of the study are not shocking and only confirm what infectious disease experts have known for years.

The reason for the South's poor survival rate is because of the cultural and behavioral issues and the stigma of the disease, Khurshid said.

"This is a confirmation that we need to do more, especially in the South. There are a number of things that need to be done here to really take care of this epidemic," Khurshid said.

Khurshid was not surprised that African-American females had the worst survival rate, though males have higher rates of diagnosis.

Females are less likely to seek medical treatment, seeking a physician only when severely ill or pregnant, Khurshid said.

"Poverty is one of the biggest things. Many of them are not insured and they don't want to pay from their pocket. Many times they don't have access to a nearby medical center," Khurshid said.

For a preventable disease that's been around three decades the fact it is still an epidemic is dismaying, though Khurshid knows it won't change soon because it depends on people's willingness to change their lifestyle, behaviors and seek appropriate care.

"It comes down to how much they know about it. How much do they know about transmission, treatment options. But this disease is still at the top. More than 30 years later it's still an epidemic," Khurshid said.

The stigma of HIV/AIDS causes many to avoid testing and treatment, which results in higher mortality rates. In the South, that stigma is even greater.

"When they are afraid to discuss it with family, how can they look for any support? Then they're alone, depressed, anxious and don't want to tell anybody," Khurshid said.

HIV/AIDS education is the best method to reverse the stigma.

Go Care director Richard Womack said education, awareness, protection and testing are the main resources in fighting the spread of HIV/AIDS.

Go Care provides prevention education and direct services to stop the spread of HIV disease and to assist those infected by HIV/AIDS.

"Everyone needs to get tested at least once a year regardless of risk factors in lieu of there not being a cure for HIV. It only makes sense the more people we can identify and get them into medical care the less likely they will transmit the virus," Womack said.

But people are waiting late into the progression of their disease before they get tested. They wait until they have problems and show up at emergency rooms with illnesses associated with HIV infection, Womack said.

The Centers for Disease Control and Prevention recommend sexually active adults get tested at least once a year and three to six months after possible exposure of HIV. Go Care provides prevention education, free testing and direct services to stop the spread of HIV disease and to assist those infected by HIV/AIDS.

The Louisiana Office of Public Health reported 1,803 cases of HIV/AIDS in northeastern Louisiana with 766 deaths in 2014.

Latest data released last year show 19,087 people living with HIV/AIDS in Louisiana. The cumulative number of deaths among persons diagnosed with HIV/AIDS, reported to the Louisiana Office of Public Health through 2014 is 14,666.